The mayor made a tour of hotels catering to the homeless in the Tenderloin area, often stopping and talking with homeless along the way...he filled out a survey as he walked for this homeless woman...part of the massive outreach program by city workers.
During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area.

Photo: Brant Ward

The mayor made a tour of hotels catering to the homeless in the...

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Billie Washington looks out the window of her new hotel room at the Bristol Hotel on Eddy Street...she has just gotten inside.
Billie Washington gets yelled at by a local merchant for laying on the sidewalk...although everyone admits she keeps her area cleaner than anyone.
Brant Ward 10/6/04

Photo: Brant Ward

Billie Washington looks out the window of her new hotel room at the...

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Outreach workers stop to help a woman on Sixth Street in San Francisco...outreach teams regularly patrol this area of the city known for homelessness and drug use. Here they stop to help a woman in a wheelchair named Lillian who is trying to get into a shelter.
In 2004, the city of San Francisco started to implement the Care Not Cash program. One aspect of the program was to send outreach workers into the streets to contact the chronically homeless people and try to place them in hotel rooms. On Jones Street in the Tenderloin, several homeless people were helped inside, while others proved more difficult.
10/14/04 Brant Ward

Photo: Brant Ward

Outreach workers stop to help a woman on Sixth Street in San...

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David Nakanishi, left, outreach team leader, stops to talk with "Cowboy", a longtime homeless man on Jones Street. Efforts to get Cowboy inside have so far failed.
In 2004, the city of San Francisco started to implement the Care Not Cash program. One aspect of the program was to send outreach workers into the streets to contact the chronically homeless people and try to place them in hotel rooms. On Jones Street in the Tenderloin, several homeless people were helped inside, while others proved more difficult.
6/1/04 Brant Ward

Photo: Brant Ward

David Nakanishi, left, outreach team leader, stops to talk with...

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Mayor Newsom stopped and talked with Cynthia, a homeless woman on Jones Street, during a tour of hotels helping the homeless. He then escorted her to counselors up the street.
During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area. It is clear that the fate of the homless is a very important issue for the first-term mayor.
10/14/04 Brant Ward

Photo: Brant Ward

Mayor Newsom stopped and talked with Cynthia, a homeless woman on...

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Early in 2004, Mayor Newsom held a press conference at the McAllister Hotel talking about the need for hotels to house the homeless...he went upstairs to one room which even had a view of City Hall.
During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area. It is clear that the fate of the homless is a very important issue for the first-term mayor.
11/15/04 Brant Ward

Photo: Brant Ward

Early in 2004, Mayor Newsom held a press conference at the...

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outreach075.jpg
Outside the Empress Hotel on Eddy Street, Mayor Newsom and a homeless person got into a discussion about personal records being kept for the hotel tenants under Care Not Cash programs. Mayor Gavin Newsom spent Wednesday morning walking around the Tenderloin and Civic Center areas with his new outreach workers talking with homeless. He also piloted a street cleaner and rode it back to City Hall BRANT WARD / The Chroniclenewsomhomeless001_ward.jpg
During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area. It is clear that the fate of the homless is a very important issue for the first-term mayor.
8/4/04 Brant Ward

Photo: Brant Ward

outreach075.jpg
Outside the Empress Hotel on Eddy Street, Mayor...

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Dr. Josh Bamberger, left, Housing and Urban Health director for Public Health, leans over the table to help Wayne Brown. Wayne is a homeless man on Jones Street who is waiting to get a place inside. The doctor is talking about health care with Wayne.He is at the Pierre Hotel on Jones Street. the In 2004, the city of San Francisco started to implement the Care Not Cash program. One aspect of the program was to send outreach workers into the streets to contact the chronically homeless people and try to place them in hotel rooms. On Jones Street in the Tenderloin, several homeless people were helped inside, while others proved more difficult.
10/13/04 Brant Ward

Photo: Brant Ward

Dr. Josh Bamberger, left, Housing and Urban Health director for...

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The mayor embraced an unidentified city worker, who was one of hundreds called out to survey the homeless. They are standing on the steps of the Elm Hotel...one of the hotels designated to house the homeless.
During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area. It is clear that the fate of the homless is a very important issue for the first-term mayor.
10/13/04 Brant Ward

Photo: Brant Ward

The mayor embraced an unidentified city worker, who was one of...

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Inside the Elm Hotel on Eddy Street, one of the hotels designated to house the homeless, the mayor had a discussion with a homeless man named Robert, who was seeking services.
During 2004, Mayor Gavin Newsom of San Francisco went into the streets to talk with the homeless, even counseling some during a walk in the Tenderloin area. It is clear that the fate of the homless is a very important issue for the first-term mayor.
10/13/04 Brant Ward

Photo: Brant Ward

Inside the Elm Hotel on Eddy Street, one of the hotels designated...

Signs of hope replace despair Mayor's homeless plan a start / Mayor's plan to move people from streets to supportive housing brings cleaner blocks -- but the toughest cases need more help

Eleven months after Mayor Gavin Newsom took office promising to make San Francisco's seemingly intractable crisis of homelessness his top priority, the flurry of efforts he set in motion to address it has made modest -- but real -- progress.

More than 700 people have been moved off the street or out of shelters and into newly created supportive housing programs, primarily through Newsom's bitterly contested Care Not Cash plan, which slashes welfare checks to the homeless in exchange for rooms. And the number of people seeking aid under the city's welfare program for the homeless has plummeted 40 percent from 2,497 to 1,515.

A 12-person team of outreach counselors has made 4,950 contacts on the street and helped hundreds of chronically homeless people -- the most visible and hard to treat -- obtain drug rehabilitation services, medical help and housing. More than 250 volunteers joined the team for one morning in October, and that effort will be repeated at least monthly.

Traditionally warring factions in the city -- from homeless activists to business leaders -- combined forces at Newsom's request to create a much- needed plan to attack the crisis. Last summer, they produced the 10-Year Plan to Abolish Chronic Homelessness, aimed at the hard core, who are mostly mentally disabled, alcoholic or drug-addicted and have been on the streets for more than a year.

And for the first time in years, people can drive or walk along entire blocks of downtown's two major thoroughfares -- Van Ness Avenue and Market Street -- without seeing a single panhandler.

But the advances made since Newsom took office Jan. 8 have come with setbacks and have drawn criticism.

The mayor lost big on Nov. 2 when city voters rejected an affordable housing bond measure that included $90 million he wanted for supportive housing, which gives the homeless rooms in buildings, usually residential hotels, with on-site counseling to address mental and addiction problems.

Homeless activists are irritated by changes in the shelter system, particularly new rules making it harder for anyone not signing up for Care Not Cash to get a bed.

And, during an exhaustive examination of the Newsom administration's initiatives, The Chronicle found that the process of getting the homeless into housing or services involves weeks of cumbersome applications and interviews; that too many of the most dysfunctional are being left on the street; that the clearing of panhandlers from certain areas results in more panhandling elsewhere; and that the city needs thousands more rooms before it will have enough to clear the sidewalks.

Newsom and his staff remain upbeat that they will erase the city's reputation as having the worst problem with homelessness in America.

"There's no way in the world this sort of situation changes overnight," the mayor said. "That would be unreasonable to expect. But give it a year, maybe more, and we will get some lasting results. If we don't get those results, you can hold me accountable."

Sam Tsemberis, who runs Pathways to Housing in New York, one of the most successful homeless outreach and housing programs in the nation, has watched the city's progress. He said San Francisco is on the right track.

"The important thing to remember is that this approach takes a while," he said. "You have to be realistic."

Newsom's approach boils down to two main strategies.

One is eliminating the longtime practice of merely enabling the homeless to stay alive on the streets. The other is funneling the homeless into beefed- up supportive housing and other services through the Care Not Cash welfare overhaul and street-level outreach efforts, so they stay healthy enough that they won't be tempted to fall back to the gutter.

The steps taken toward these two goals represent the most forceful forward movement in a decade in San Francisco toward solving the crisis of chronic homelessness.

The Chronicle's 11 months of tracking Newsom's progress on homelessness found that the mayor's reforms are showing promise but have a long way to go.

Supportive housing

The mayor expects to have created an impressive 1,300 new supportive housing rooms by early next year, but the effort is not efficiently reaching the city's 3,000 chronically down and out. Instead, the housing is mostly going to the more functional homeless -- a phenomenon social workers call "creaming," in which the easiest-to-reach homeless get the most attention.

To understand the dynamic, one first must understand the housing program.

The welfare-cutting Care Not Cash, officially titled the County Adult Assistance Program, or CAAP, has been the main vehicle to date for creating those new housing units, and for selecting the homeless people who get to move into them. Premiering on May 3, Care Not Cash cuts the former monthly welfare payments of up to $410 to the homeless to $59 and gives the recipient instead a shelter bed or, preferably, a supportive housing room.

Some 534 of the 2,497 homeless people getting welfare before Care Not Cash -- or 21 percent -- are getting those smaller checks with the services that go along with them. Another 982, or 40 percent, simply dropped off the rolls, either because they resented the Care Not Cash dictates or moved to other counties. City officials think some people disappeared because they were illegally commuting in from other counties to double-dip welfare checks.

The $9 million saved in the homeless-welfare budget by cutting the rolls and slashing payments has been used to help pay for 793 new supportive housing rooms and services. Although some of those rooms already were filled by people living in the hotels at the time they were renovated and brought into the program, most have been occupied by homeless people through Care Not Cash.

That's where the "creaming" becomes apparent.

The "cream" of the homeless -- meaning the most functional among them who already were in shelters and often looking for jobs -- are mostly the ones moving into the new rooms. The chronically homeless -- those 3,000 whom the city most wants off the street -- are not being swept up in the housing rush.

Of the 534 people placed under permanent roofs by Care Not Cash, only 34 have been hard core, routed straight off the street by the 12-person outreach team. Virtually all of the rest came from shelters.

Newsom says he is happy to have hundreds of homeless people housed, no matter what category they come from, but he and the outreach workers agree that "creaming" is an issue. In reaction, the mayor allocated $500,000 out of discretionary funding to create a new, 90-bed complex just for the hard core by early 2005.

To demonstrate greater success housing the chronically homeless, the Newsom administration can point to growth of a city Department of Public Health program, called Direct Access to Housing, which is acclaimed by homeless experts as a national model. It receives referrals of acutely disabled, addicted or otherwise troubled homeless people from medical facilities and provides intensive on-site counseling help. This year, 190 beds were added -- and they are all filled, said Marc Trotz, the program's director.

Not all of those beds, however, went to the chronically homeless. One hundred went to senior citizens already in shelters.

The overall total so far? Counting six more chronic cases housed by the outreach team through non-Care Not Cash programs, 130 hard-care homeless have received permanent roofs -- 18 percent of 730 total homeless housed to date.

Bureaucratic inefficiencies hurt the city's supportive housing efforts in other ways. It can take weeks and several appointments -- never easy to make for people sleeping on the street and frequently suffering from mental illness and addiction -- before a homeless applicant gets face to face with a case manager to get into rehab or supportive housing.

"I've been to the welfare office three times in the past three weeks, and I still keep being told to come back and fill out paperwork," said David Rodgers, 45, who makes and sells tiny wire figurines on Market Street. "I would love to get one of those Care Not Cash rooms, because sleeping out here is killing me."

City human services managers have been scrambling to streamline the system, establishing a special housing team at the welfare office that has significantly trimmed waiting times. As urgent as the need for that streamlining is, however, the need for more housing is more pressing.

San Francisco's homeless population, including both the most functional people and the 3,000 hard core, totals 8,600 to 15,000. So even with the 1,300 new housing units expected to be available by early next year, the city is still up to 10,000 rooms short of getting every denizen of the street under a permanent roof.

The math for determining how many beds are needed is fuzzy, because many of the up-to-15,000 homeless are actually "couch surfing," meaning they rotate stays with friends and relatives. The only way to find out, experts say, is to keep creating rooms until the homeless are no longer on the streets.

The mayor was hoping voters would help last month by passing Proposition A, the $200 million affordable housing bond measure that included $90 million for supportive housing -- money that could have been leveraged into almost $300 million when paired with matching state, federal and private grants. That would have funded at least 2,000 new supportive housing units for the homeless. Prop. A was backed by 64 percent of voters but needed two-thirds support to pass.

Instead, the city is back to relying on Care Not Cash -- which Newsom has protected from budget cuts, despite a fiscal crunch -- and on state and federal government grants.

In response to the city's completion of its new 10-Year Plan to Abolish Chronic Homelessness, the U.S. Interagency Council on Homelessness steered $24. 2 million in grants to San Francisco this year for homeless housing programs. Also, newly passed state Proposition 63 will probably send as-yet-undetermined millions to the city for housing mentally ill homeless.

All of that, however, will fall short of the $300 million that might have been generated had Prop. A passed.

Outreach efforts

Nothing in Newsom's arsenal of weapons to attack chronic homelessness is more important than the 12-person street outreach team, composed of counselors from the Public Health Department, Human Services Department and other social service agencies.

Their orders are to focus on the hard core. They spend seven days a week driving and walking throughout the Tenderloin -- the 60-block, seedy expanse of downtown that is home to 85 percent of the city's soup kitchens, medical clinics and other homeless services.

"That's where the most pressing need is," Newsom said. "We can't be afraid to go right to it."

According to leader David Nakanishi, the outreach team has recorded 4,950 contacts with chronically homeless people, a number that includes multiple visits with the same individuals. Through those contacts, counselors moved 100 people into shelters or housing and enrolled at least 30 in drug rehabilitation programs.

The team also has started meeting weekly with social workers from the city's key drug addiction, poverty housing and medical agencies to compare notes on the neediest cases. This has created more cooperation among the departments than has been seen in years.

Although the number of homeless people moved indoors may seem small, outreach team members and experts say that's to be expected. This type of work is a slow, painstaking process of building trust by approaching street people over and over. Conventional estimates by national outreach experts are that it often takes eight to 10 contacts with each person before any progress begins, and frequently at least two years before someone moves inside permanently.

Panhandling

The most visible effect of the city's campaign on homelessness this year has been the near disappearance of panhandlers from Van Ness Avenue and parts of Market Street, particularly near Ninth and Third streets. The reason: enforcement of Proposition M, the anti-panhandling law written by Newsom and passed by voters last year.

Police have been walking the areas since the law went into effect May 25, warning the homeless that if they didn't stop panhandling in traffic or near automated teller machines, they'd be ticketed. Officers also have roped or fenced off some of the main hangouts for the homeless, preventing them from sitting in the way of passers-by -- "gently changing behavior," as Newsom calls the tactic.

Only nine tickets have been given out in the campaign, and nobody has been arrested, a reflection of the view held by Newsom and police officers alike that jailing the homeless doesn't help. They always return to the same spot when they get out.

The flipside of Prop. M's success, though, is that many of the panhandlers set up shop a few blocks away from where they were shooed off. This aggravates some merchants in the new areas -- but those who benefit are thrilled.

"We've definitely seen a big difference, and people feel a little bit safer," said Carolyn Diamond, executive director of the Market Street Association. "In other administrations, there would be a push that would last a couple months and then it would go back to normal. Not this time."

Another quandary is that the very housing programs designed to take panhandlers off the street don't do much to keep them from begging. After the homeless move inside, many still spend their days with cups in hand at the same street corners or freeway ramps they left. They say they can't survive on the $59 plus about $100 in food stamps they get monthly under the welfare housing program.

Shelters

The main homeless shelter in the city, Multi-Service Center South on Fifth Street, is now open 24 hours a day to give the homeless refuge and counseling, and Newsom has pledged to place all 149 senior citizens now in the city's 15 shelters into permanent housing by year's end. Also, many of the wooden shelter beds in the city have been traded in for metal ones over the past year to eliminate a nasty bedbug infestation.

But though the homeless welcome these moves, they complain that Care Not Cash has made it harder for some to get in the door at shelters. Those who sign up for welfare are assured shelter spots for several weeks at a time, but most who are not signed up must reregister for beds every day, waiting for hours in long lines at check-in centers.

"It's outrageous," said Paul Boden, head of the Coalition on Homelessness. "Nobody's paying attention to this, because the people who run the shelters monitor themselves."

The Newsom administration makes no apology for rewarding those who play ball with Care Not Cash. But the mayor's chief homeless adviser, Department of Human Services Executive Director Trent Rhorer, says he is looking into making it easier for those outside the system to get into shelter.

A Board of Supervisors committee recommended on Nov. 10 that an independent monitoring panel be set up to inspect the city's shelters. Officials at the Department of Human Services, which runs the system, said the move is unnecessary because there are already at least three city oversight panels that respond to shelter complaints.

10-year plan

The city's 10-year plan to end chronic homelessness, presented on June 30 to Newsom by a team led by former Supervisor Angela Alioto, is focused on redirecting city resources into creating supportive housing. Ultimately, Alioto wants to see all but a handful of the city's shelter beds shut down and homeless people placed straight into permanent rooms with counseling, even if they are still struggling with substance abuse -- which would be in direct line with a "housing first" practice that has met great success in New York and Philadelphia, and that the city is already aggressively starting to adopt.

"The shelters should just become crisis centers, and the minute a homeless person comes into any contact with a social service in this city, they should be put on a fast track for housing right then and there," Alioto said. "We shouldn't even need an outreach team if we do it right."

The plan will require undetermined funding, which will be hard in a year where city officials already are considering new cuts in drop-in and medical care -- particularly at the Tom Waddell Health Center, which serves up to 8, 000 homeless people a year.

Just to remind himself of what he's up against, the 37-year-old Newsom drives or walks through the city's main homeless haunts every day or so. Rhorer, his 35-year-old homelessness adviser, frequently accompanies him.

On one of their strolls in late September, Newsom and Rhorer tossed ideas back and forth nonstop, arguing good-naturedly about everything from shelter hours to how to create better food programs. In these times, even in their unguarded moments when they think nobody is listening, they sound like social workers trying to figure out how to save everyone in sight.

"I'm sick and tired of seeing people dying on the streets, of seeing open- air drug dealing, aggressive panhandling, homeless people in despair," Newsom said. "We've got to take back San Francisco without criminalizing a certain class of people -- the homeless -- and make life better not just for them, but for everyone here."

"We can do this, you know we can!" Rhorer said, pumping his fist.

The two were on Market, near Seventh Street, and they stopped to chat with every homeless person who looked up.

"Housing, that's what you really need, isn't it?" Newsom asked Marcus Smith, 32, who approached him near Jones Street to complain about how cold he got sleeping on the sidewalk.

San Francisco Mayor Gavin Newsom built his campaign on reforming the city's homeless services. When he entered office in January, the city had the nation's worst hard-core homeless problem -- with at least 3,000 people panhandling, sleeping, drinking and shooting drugs on the street every day. Reporter Kevin Fagan and photographer Brant Ward have tracked the city's progress under Newsom since his Jan. 8 inauguration.

Today: San Francisco is moving hundreds of people into housing and treatment programs but still has a long way to go.

Monday: The painstaking, day-to-day struggles of San Francisco's new homeless outreach team.

Tuesday: Inside the new housing programs San Francisco is counting on to help solve its homeless crisis.

The progress made.

8,600- 15,000

Estimated overall

homeless population

in San Francisco, which has the nation's most visible homelessness problem. .

3,000

Minimum number of chronically homeless people

estimated to be in San Francisco when Mayor Gavin

Newsom took office in January..

730

Total number of homeless people moved into supportive housing through city initiatives since May, when the new Care Not Cash homeless welfare reform took effect..

40

Percentage drop-off in the number of people in the welfare

program for the homeless since the advent of Care Not Cash.

The project

San Francisco Mayor Gavin Newsom built his campaign on reforming the citys homelessservices. When he entered office in January, the city had the nations worst hard-core homeless problem  with at least 3,000 people panhandling, sleeping, drinking andshooting drugs on the street every day. Reporter Kevin Fagan and photographer Brant Ward have tracked the citys progress under Newsom since his Jan. 8 inauguration..

Today: San Francisco is moving hundreds of people into housing and treatment programs but still has a long way to go. .

Monday: The painstaking, day-today struggles of San Franciscos new homeless outreach team..

Tuesday: Inside the new housing programs San Francisco is counting on to help solve its homeless crisis.

Newsom's new initiatives

Creation of supportive housing units, residential rooms with counseling services in the building.

A 12-person homeless street outreach team, made up of social workers drawn from several city departments.

Completion of a 10-Year Plan to Abolish Chronic Homelessness, which qualifies the city for stepped-up federal funding for homeless services.

Homelessness by the numbers

Number of interviews done by outreach team with homeless people on the street

4,950.

Experts' estimate of how long it can take for an outreach team to get a homeless person to move inside permanently

2 years.

Total number of new supportive housing rooms created by the city

983.

Cost of creating those new 983 supportive housing rooms

$10 million.

Number of homeless people who were getting welfare seven months ago when Care Not Cash began

2,497.

Number of homeless people getting welfare of any kind now (either cash aid or cash plus housing)

1,515.

Number among that 1,515 now getting welfare who converted from simply receiving a monthly check to getting housing plus a reduced check under